BACKGROUND With increasing age, people are more likely to live with multiple health conditions, be prescribed more medications, and require support from a wide range of services within the health and social care sector. In the context of constrained budgets, it is a challenge for the UK to deliver a welfare system that supports older adults living with frailty within the community. It is certainly not unique across developed countries to be facing this paradox. 1 The authors' wish to highlight the potential case for investing in the creaking social care system, following recent policy changes promoting spending in adult social care through the Better Care Fund and broader changes in funding streams. 2 THE PRESSURISED SOCIAL CARE SYSTEM The challenges facing the UK's social care services is well documented, with an Age UK report estimating that, in England, 54 000 people-or 77 a day-have died while waiting for a care package in the 700 days since the UK government declared in March 2017 that it would publish its social care green paper. 3 This remains unpublished, with the government now missing five consecutive deadlines. The issue has been brought back into the political limelight after the House of Lords Economic Affairs Committee published their report titled Social Care Funding: Time to End A National Scandal, in July 2019. 4 The committee recommended an immediate injection of 8 billion GBP, followed by a further 7 billion GBP a year to extend NHSstyle free personal care to all by 2025/2026, paid for out of general taxation. There is a clear precedent, with free personal care already provided in Scotland for those aged 65 years and over, and younger patients with degenerative neurological conditions. In the UK, social care is funded and delivered through local authorities. In England, a significant proportion of funding for social care flows from Government on a formula basis, with local councils able to use local taxes in addition to central state funds. Locally delivered social care services
This paper describes a study investigating medical students' responses and levels of recall from a live and televised version of the same lecture. Although no difference in immediate recall was found, a significant difference was found one week later. The groups who had seen the live lecture were able to recall significantly more from the lecture than those who had seen the televised transmission. No differences were observed in the amount and type of note-taking and in the levels of attention and interest of the two groups of students. Some possible reasons for this significant effect on delayed recall are discussed and directions for future work are identified.
Background In 2017, two GPs decided to form the GeriGP group, for BGS GP members with a particular interest in the care of older people. GPs are increasingly using their holistic approach and expertise in new models of care within the community and the acute setting ("GeriGP" roles), and many no longer work in traditional General Practice. Introduction By late 2018, the group had around 100 members. The committee recognised the vital role GeriGPs could play in the development and delivery of innovative models of care for older people, as recommended in the NHS Long Term Plan1 and 2019 GP Contract2. There was no data available about GeriGP roles, which appeared to have arisen in an ad hoc fashion. An online survey was undertaken with the aim of using the results to engage with national policy makers and to identify pathways into these roles to improve recruitment and retention of the GP workforce.3 Methods We are grateful to the BGS who collated 58 questions for the online questionnaire, which was sent to all GeriGP members between October and December 2018. There were five main categories: role and venue; employment conditions; indemnity; appraisal; qualifications and training. Most questions had space for free-text comments. Results 47/100 GeriGP members responded; 68% respondents held GeriGP roles of whom 62% were practising GPs. 60% of all respondents were over 45 years old. 30 job descriptions covered community frailty hubs, intermediate care, community hospitals, care homes, acute front door, visiting services and memory clinics. 60% were community based. Rates of pay and types of contract varied dramatically. GP appraisal was often difficult due to patients having frailty or dementia, with contradictory advice common. 45% had difficulty accessing training and two-thirds of jobs were gained by word-of-mouth. 87% in GeriGP roles were more likely to continue practicing medicine because of this role, yet career development barriers existed at all levels. Many comments concurred with a plea for a ``primary care geriatrics specialty'', and repeatedly the joy of having time for patient-centred care was the driving force behind experienced GPs opting to continue in GeriGP roles. Conclusions The enthusiasm for GeriGP roles should be seized upon to improve healthcare of older people and bolster the GP workforce. GeriGPs plan to use these results to influence policy makers nationally. References 1. NHS Long Term Plan (https://www.longtermplan.nhs.uk/online-version/overview-and-summary). 2. 2019 GP Contract (https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf). 3. GeriGPs. (https://www.bgs.org.uk/gerigps).
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